Disaster Preparedness

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Disaster Preparedness Mitigationin Health
System
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Disaster Preparedness

• Definition
• Activities designed to minimize
  loss of life and damage, to organize the
  temporary removal of people and property from a
  threatened location facilitate ,timely
  effective rescue, relief rehabilitation

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Disaster Preparedness contd

• National International agencies conduct
  activities like planning, organization ,training
  communicating ,educating the people to provide
  prompt and appropriate responses to prevent
  reduce adverse effects.
• Ongoing ,multisectoral activity
• Integral part of national system responsibility
  
• Difference in developed and developing countries
  (infrastructure, resources, management capacity,
  communication logistic problem)

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Objectives

• To prevent excess mortality by impact, rescue,
  relief , appropriate health care disruption .
• To provide appropriate timely health care for
  casualities,malnutrition comm. Diseases.
• To prevent exposure to adverse climatic
  environmental conditions.
• To prevent long term short term disaster
  related morbidities.
• Reestablishment of health services to or above
  the pre- disaster level.

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General model of disaster preparedness plan

1. Identify the hazards and estimate their effects.
2. Assess the likely needs preliminary list, local
   capacity, quantify the needs, consider basic
   needs.
3. Discuss the needs teams involved in planning
   process
4. Determine operational procedure review
   existing priorities. --- provide frame work,
   hazard prioritization, fundamental policy set
   out, goals approve by higher authority,
   delegation of responsibility.

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General model of disaster preparedness plan
contd

• 5. Assign the responsibility.
• Make an inventory of local capacity available
  resources.
• 7 Review steps 2 5
• 8. Identify critical areas-----strengthening
  monitoring plan
• 9. Confirm priorities ---needs resources, time

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General model of disaster preparedness plan
contd

• .
• Finalize the plan ---easy to read, not rigid,
  standard layout
• Practice the plan reg.reviewed , updated,
  responsible people, identify weakness.
• Evaluate the plan ---lesson learned applied
• Compile an information package demography,
  epidemiology, Geographic Information System (GIS)

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Technical Health Program

• Treatment of casualties
• Pre hospital plan - search rescue of
  victims, first aid at disaster site (triage)
• Hospital plan emergency plan, training
  information safety of pts health personnel.
• Back up system water, power, communication,
  transportation.

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Technical Health Program contd

• 2. Identification of bodies coordination with
  FM, protocol for identification transport.
• 3. Epidemiological surveillance disease control
  ---simple data collection ,warning mechanism
  with list of potential illnesses ,special
  programmes for diseases
• Basic sanitation sanitary Engineering
  collaboration with diff.departments ,contingency
  plan

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Technical Health Program contd

• 5. Health management in shelters or temporary
  settlements---control of infectious diseases,
  vaccination of children, nutrition surveillance
• 6. Training Health personnel public health
  management ---in service training ,professional
  staff, professional curriculum, research,
  officers ongoing information
• 7. Logistic resources---budget, networking
• 8. Simulation exercisesdesktop, field exercise,
  drills

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Technical Health Program contd

• Evacuation temporary transfer of population from
  areas at risk to safer location.
• Organized e.g..
• (tropical storm air attack,military action,
  industrial accidents)
  
• Spontaneous e.g..
• (floods,drought,chemical nuclear
  accidents)
• Environmental health services --short travel
  time ,clean potable water,excreta solid waste
  rest stop knowledge
• Disaster warning simple language ,clear exact
  nature of message.
• Restore of radio broad casting

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Health policy legislation

• Legislation to develop preparedness response
  plan, routine, simulation assign financial
  resources.
• Coordination mechanism health disaster
  coordinator -Incharge of preparedness
• activities ,
• - coordinating plans with
  Government ,International agencies, NGOs
• other dept.. water, housing power
  ,communication
• -communication co
  ordination with PAHO, WHO civil protection
  agencies, emergency preparedness program.

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Mitigation and prevention

• Definition
• These are actions aimed at
  reducing or eliminating the impact of future
  hazard events by avoiding hazard or strengthening
  resistance to it.

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Objectives

• Reduce vulnerability of the system
• e.g. improving enforcing building codes
• Reduce magnitude of hazard.
• e.g. diverting flow of river

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Vulnerability and capacity assessment

• Definition
• It is the degree to which population,
  individual, or organization is unable to
  anticipate, cope with resist recover from the
  impact of disaster .(Blaikie 1994)
• Risk ,threat assessment
• To identify hazard their possible effects,
  capacity to prevent respond
• Develop strategies
• Emergency prevention mitigation preparedness
  measures
• Rapid, relevant emergency response
• Gaps in resources

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Vulnerability reduction
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Steps in VCA

1. Determine aim, objectives, scope context of VCA
   task.
2. Formation of planning group .
3. Hazard identification description.
4. A community environmental description
5. Determining effects community vulnerability
6. Hazard prioritization
7. Recommendation for action
8. Documentation of results decision

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Mitigation Programme

• Identify areas exposed to natural hazards with
  help of specialists.
• Coordinate the work of multidisplinary teams in
  developing design building codes.
• Include disaster mitigation in health sector
• Identify the priority hospitals critical
  health facilities -----current building standards
  codes.

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Mitigation Programme

• Ensure disaster mitigation measures in maintains
  plan, structural modification functional
  aspects.
• Inform sensitize train those personnel
  involved in planning, administration, operation,
  maintenance .
• Include disaster mitigation in the curricula of
  professional training institution related to
  construction, maintenance, administration,
  financing planning health facility

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Disaster Mitigation

• Health facilities loss of life, hospital
  functions
• Structural
• Non- structural
• Administrative /organizational
• 2.Drinking water supply ,sewage system.
• 3. Mitigation to reduce community vulnerability.

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Disaster mitigation in health system

• Structural vulnerability part of building
  required for support (foundation, columns, beams,
  diaphragm supporting walls )
• Non-structural vulnerability
• Joined to building structure e.g. window,
  door, roof
• Building functionality e. g. plumbing,
  air-conditioning, power, water, communication.
• Items located with in building e.g. medical,
  furniture, mechanical equipments

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Disaster mitigation in health system contd

• 3.Administrative organizational vulnerability
• Physical design external site, internal ,
  distribution of space, access route.
• Physical functional relationship with diff.
  sectors e.g. hiring, maintenance, supply.
• Administrative operational facility disaster
  management, simulation exercises

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Mitigation measures

1. Start with low cost measures e.g. Non structural
2. Implement mitigation at National, local level
   discussion with all parties (client, owner,
   finance officer technical personnel)
3. Measures 4-8 of total hospital costfailure of
   systems

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Disaster mitigation in water supply sewage
system

• Water supply sewage system vulnerable
• Outbreak of communicable disease sanitation
  deteriorates. e.g. Mexico city in1985
• Strategies to quickly effectively restore
  system
• Hazard analysis by team focus on operation
  maintenance, administration impact on service.
• Mitigation measures in master plan.
• Measures retrofitting ,replacement, repair,
• Back up equipments relocation of components
  (rigid joints, flexible pipes).

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Mitigation to reduce to community vulnerability

1. Reduce risk of communicable diseases.
2. Improve general health status of population
3. Water sanitation projects organized by self
   help basis e.g. community based organization
4. Local emergency planning in disaster
5. Public education
6. Discussion with water vendors
7. Intervention by Government municipal
   authorities in industrial plant contamination

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References

1. Natural disasters protecting public health WHO
   publication.
2. Principals of disaster mitigation in health
   facility PAHO publication.
3. Environmental health in emergencies disaster.
4. Text book of PARK
5. Indian journal of public health Jan-march 1992

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Thank you